Active NPI
Lacey Boehmer, CPM, LDEM
- Midwife
- Holladay, UT
National Provider Identifier
1407640949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 11409200-3400
- Practice address
- 4359 S Highland Dr
Holladay, UT 84124-3539 - Phone
- (888) 755-7155
- Fax
- (801) 723-3115
- NPI assigned
- Apr 8, 2025
- Last updated
- Apr 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 11409200-3400 | UT | Primary |
Addresses
Primary practice location
4359 S Highland Dr
Holladay, UT 84124-3539
Mailing address
941 W Zaffre Hills LN
Bluffdale, UT 84065-2004
Phone (385) 205-7010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11409200-3400 | UT | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innate Midwifery LLC | Midwife | Current | Accepting new patients |
Locations
4359 S Highland Dr
Slc, UT 84124
Phone (760) 815-6923
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1407640949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 W ZAFFRE HILLS LN",
"city": "BLUFFDALE",
"state": "UT",
"postal_code": "840652004",
"telephone_number": "385-205-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4359 S HIGHLAND DR",
"city": "HOLLADAY",
"state": "UT",
"postal_code": "841243539",
"telephone_number": "888-755-7155",
"fax_number": "801-723-3115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHMER",
"first_name": "LACEY",
"credential": "CPM, LDEM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-08",
"last_updated": "2025-04-08",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "UT",
"license": "11409200-3400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holladay, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.